Echocardiography is an essential tool to predict and measure fluid responsiveness, according to a recent article, which provides a practical guide. Ashley Miller and Justin Mandeville outline the physiological basis of fluid resuscitation, and describe how fluid responsiveness can be assessed with echocardiography.

Echocardiography is an ideal imaging modality for rapid assessment of the circulation in the shocked patient. It usually elucidates the cause, whether cardiac ischaemia, cardiomyopathy, acute valve disease, tamponade, significant pulmonary embolism, aortic root pathology or distributive shock. This article has focused on the fluid optimization phase of resuscitation.

Intravenous fluid boluses can benefit the circulation but also cause harm. The presence of signs that fluid delivery improves cardiac output does not mean that a greater cardiac output is necessary.

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